Individual
DR. TYLER CHANCE DEVAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
500 N MONTE VISTA ST STE 1B, ADA, OK 74820-4670
(580) 276-1834
(580) 559-0658
Mailing address
500 N MONTE VISTA ST STE 1B, ADA, OK 74820-4670
(580) 967-1817
(580) 967-0818
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6385
OK
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0224
OK
Other
Enumeration date
06/27/2012
Last updated
02/03/2021
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